Financial Incentives for Medical Assistants May Improve Care Delivery

Financial incentives for medical assistants have the potential to increase their motivation at work and improve the quality of the care they provide, according to a study in The Annals of Medicine.

Medical assistants are key members of the healthcare workforce and can have a significant impact on population health outcomes, but they are often the lowest-paid members of the team.

Researchers conducted a series of focus groups at 10 primary care clinics between August and December 2019 to glean medical assistants’ perspectives on financial incentives. The clinics were affiliated with University Healthcare Alliance, Stanford Health Care, or Intermountain Healthcare.

Each clinic had between four and nine participants, producing a total of 59 medical assistants who participated in the study.

During the focus groups, the medical assistants shared their past experiences with performance incentives, reacted to hypothetical financial incentives, and indicated their perceived levels of control over population health measures.

Most of the medical assistants had no experience with financial incentives. One clinic offered nonfinancial incentives based on performance thresholds, such as a “jeans day” and free food. Some medical assistants felt motivated by these nonfinancial incentives, but others did not, according to the results.

Other medical assistants reported experience with financial incentives that were not linked to performance outcomes. A few medical assistants received year-end bonuses based on the number of hours they worked, ranging between $100 and $500.

The majority of the medical assistants responded positively when the focus group leader presented them with a hypothetical financial incentive of $250 every three months. Some participants mentioned that it would be better than a physical object as an incentive, and another suggested that the financial incentive may increase their satisfaction and happiness while working.

Physicians may receive financial incentives for work that a medical assistant played a part in, according to one of the study participants, and financial incentives may help make up for this offense.

However, a small portion of the medical assistants said they would prefer a raise to their hourly wage rather than any kind of financial bonus. Some did not consider it valuable to be incentivized for something that is considered part of their job.

The concept of financial incentives also raised concerns for some medical assistants. Some were worried that incentives might draw attention away from patient outcomes that are important but hard to measure. One medical assistant said that incentives should not only be associated with population health outcomes, as there is more to the job than that.

The focus group discussions that oftentimes when a medical assistant does not complete a task, it is due to a lack of effort, not a lack of knowledge or skill.

“We’re supposed to do a lot of things every time that people don’t do,” one of the medical assistants reported.

Tasks such as reaching out to outside organizations to obtain medical records are often left uncompleted, participants noted.

Medical assistants indicated that financial incentives could help close these gaps and increase effort when it comes to completing required tasks.

The study results suggested that if health systems implement performance-based financial incentives for medical assistants, they should start with applying the incentives to processes that medical assistants can complete in one day.

The majority of the study participants felt that they had the most control over same-day population health measures, such as depression screenings, body mass index screenings, and flu vaccinations.

However, some medical assistants reported that there are some external barriers to closing population health gaps that cannot be solved with financial incentives, such as a lack of time, poor patient compliance, and lack of physician follow-through.

“As health care systems nationwide aim to improve population health measures, it may be a savvy use of limited resources to focus incentives more on MAs,” the study concluded.